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NPI Code Detail

MEDICARE: CONNECTICUT RIVER VALLEY DENTISTS, PC

MEDICARE: CONNECTICUT RIVER VALLEY DENTISTS, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN22331MA
2122300000XDentistDN22332MA

General Provider Information

NPI Number : 1750643722
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONNECTICUT RIVER VALLEY DENTISTS, PC
Provider Business Mailing Address
First Line : 138 RUSSELL ST
Second Line :
City : HADLEY
State : MA
Zip : 01035-9533
Country : US
Telephone Number : 413-584-6275
Fax Number :
Provider Business Practice Location Address
First Line : 138 RUSSELL ST
Second Line :
City : HADLEY
State : MA
Zip : 01035-9533
Country : US
Telephone Number : 413-584-6275
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. SUMEET SAXENA
Credential : DDS
Telephone Number : 973-687-5542
Provider Enumeration Date : 06/14/2012
Last Update Date : 08/28/2012

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Directions to “CONNECTICUT RIVER VALLEY DENTISTS, PC ” Practice Location

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